**7. Conclusions**

Atherosclerosis is the leading cause of death in SLE and is responsible for substantial morbidity related to cardiovascular events, cerebrovascular accidents, and peripheral arterial disease. SLE patients are at increased risk of atherosclerotic disease due to traditional and nontraditional risk factors (e.g., disease activity and long-term glucocorticoid use). Clinicians should be aware of the need to limit the impact of nontraditional risk factors in order to reduce the burden of atherosclerotic disease in SLE. Current risk prediction tools likely underestimate cardiovascular risk in this population, thus further studies are needed to validate their use in SLE. The utility of imaging modalities for the routine assessment of subclinical cardiovascular disease has not yet been established and should remain a research priority. Hydroxychloroquine remains a mainstay in SLE management, as it provides additional cardioprotective benefit. Significant improvements in SLE survival over recent decades were largely due to disease-modifying therapies. With morbidity and mortality now largely related to accelerated atherosclerosis, evidence-based preventative strategies should be implemented to establish further gains in survival moving forward.
